As Washington prepares to revisit the subject of health-care reform, perhaps some fresh experience from Middle America would be of value. When I was elected governor of Indiana five years ago, I asked that a consumer-directed health insurance option, or Health Savings Account (HSA), be added to the conventional plans then available to state employees. I thought this additional choice might work well for at least a few of my co-workers, and in the first year some 4% of us signed up for it. In Indiana's HSA, the state deposits $2,750 per year into an account controlled by the employee,...